Practices

The same loss of appetite means very different things in different children. A slight child who was already struggling to gain weight may need a different formulation or a different medicine altogether.

For a sturdy child a smaller lunch is a nuisance. For one with nothing spare it is a reason to change the plan. Non-stimulant options exist and are…

Every workplace runs on a map nobody prints: who really decides, who to ask, what the polite route is. Picking that up by osmosis is exactly the channel that struggles here.

So you follow the written process, do it correctly, and it goes wrong anyway, and nobody can tell you why. The repair is to have it taught rather…

When appetite disappears at lunchtime, work with the child's rhythm instead of against it. Feed them properly at the hours they are actually hungry, which is usually breakfast and then the late afternoon and evening.

What counts over a week is the total, not whether it arrived at the socially correct hour. A decent breakfast before the medicine takes hold, a light…

Non-stimulants are usually tried after the stimulants rather than instead of them, mostly because they are harder to tolerate. That is about order, not about the drug being second rate.

There are people for whom one is the right first choice: tics, real anxiety alongside, a history that makes a stimulant a poor idea, or a body that…

If you are not the one prescribing, you can still take an active part in the medication conversation. You see the person weekly and hold the ordinary detail their prescriber never gets to see.

Ask what they notice and write it down in their own words. With their permission, send the prescriber a short note that can be read in a minute: when…

A child who has spent years being told they are careless will often say yes to whoever finally seems glad of them. Work on how they see themselves is not a soft extra to the clinical work.

Count the corrections in a single day and it is easy to see what accumulates. By the time an offer comes from someone friendly, the pull is belonging…

Most people who try do find something that helps, but often not the first thing they try. Not responding to one class of stimulant says surprisingly little about the other.

The high response figures you may have read come from people who worked through more than one option, not from one prescription going well. Response…

When you need to correct one person, say it to the room. Everyone gets the instruction and nobody gets the sting.

Good instructors do this without thinking: they see one child dropping their guard and say that everybody needs to keep their hands up. The teaching…

When someone describes a day like that, do not answer with a lecture on living better. Say that this is hard, and that you find parts of it hard too.

They have heard the virtue speech many times already and it has never once helped. Admitting that you also struggle to exercise, or to keep up with…

Teaching a child to fight works better when it comes with a plain rule: you defend, you never start it. The rule is doing as much work as the training.

A child whose brakes are slow benefits from having the decision made in advance, out loud, many times over. Then it is not something to work out in…

A scheduled break does not break concentration. It is the unplanned wandering off that does that, and a known break tends to replace it.

Teachers usually expect movement breaks to shatter the lesson and find the opposite: children come back more easily because the break is part of the…

When nobody has checked whether a benefit lasts, that is not the same as finding out it does not. Following people up for a year costs money that most studies never had.

Two mistakes sit either side of this. One is reading a gap in the evidence as bad news. The other is assuming something lasts because a trial…

Speech has a beat inside it. When a child cannot hold a steady rhythm, that often sits alongside difficulty with reading and with the flow of talking, so time spent clapping or tapping a beat together is doing something real.

You need nothing for this. Clap a slow pattern, ask them to clap it back, then keep it running while you both count or walk in time to it.…

Start the movement slow enough that it is almost boring. Speed it up once it has gone smooth, and only then add the thinking part.

Throwing a beanbag back and forth, bouncing a ball, drumming on the table: pick something plain and let it become automatic before you make it…

When somebody does not take up the movement you suggested, ask what got in the way before deciding they did not want to. Usually it is money, childcare, transport or time.

Cost, an awkward class time, nobody to watch the children, a room full of people you would have to make conversation with. None of that is…

If you are the therapist, you do not need to become the movement teacher as well. Sending somebody to a person trained for it is the better version of helping.

The evidence is for movement alongside therapy, not for therapy with a few stretches added by someone who picked them up from a video. Handing it…

Arrange to meet someone. A neighbour at the gate at eight, a friend expecting you, even an app counting a streak. Turning up for someone else is easier than turning up for yourself.

Benefits that arrive in six months are weak motivators. Something that pays out today works better: a person waiting, a number that goes up, a…

Bolt the movement onto something you would want to do anyway. A game with a friend, a walk to somewhere with good coffee at the end, a route past the river.

People keep up a weekly game with a mate for forty years and never once call it exercise. The friendship is what they turn up for and the moving…

Clumsy is not a description you can work with. Balance, core strength, shifting your weight, big movements, small ones, catching a ball, keeping a beat: those you can look at one at a time.

Break it down and you usually find a child is fine in four of those and struggling in two. That turns a vague sense that they are awkward into…

Not every family can get occupational therapy. Almost anyone can get outside with a skipping rope, a long rope turned by two people, or a board.

Skipping and boarding ask for much of what a therapist would be working on anyway: both sides of the body keeping time with each other, judging the…